Child psychopathology

Child psychopathology is the manifestation of psychological disorders in children and adolescents. Oppositional defiant disorder, attention-deficit hyperactivity disorder, and pervasive developmental disorder are examples of child psychopathology. The full list of formal diagnostic codes and classification of mental health disorders can be found in the DSM IV TR; this is the same manual which covers adult psychopathology, but it has certain diagnoses specific to children and adolescents. --Childpsypro (talk) 03:35, 13 December 2011 (UTC) Counselors, social workers, psychologists and psychiatrists who work with mentally ill children are informed by research in developmental psychology, developmental psychopathology, clinical child psychology, and family systems. The first section of the DSM IV-TR Disorders usually first diagnosed in infancy, childhood or adolescence includes diagnoses from mental retardation to selective mutism. In addition, the DC 0-3 or Diagnostic Classification 0-3 is used to assess mental health problems in infants. Selma Fraiberg was one pioneer in the field of Infant mental health.

How a diagnosis is made

Often parents first meet with the pediatrician to assess whether a child's symptoms merit further psychiatric evaluation. In order to assess child psychopathology, a licensed professional (often a psychiatrist, psychologist or social worker) will conduct a diagnostic interview to assess symptoms, their frequency and severity. The professional will often also use scales completed by the youth, parent and teachers to assess child functioning. An assessment of eating and sleeping patterns, mood, school performance, birth history, family history, medical history and present risk levels are all part of this evaluation. After assessment, the professional may make a diagnosis as to what condition is causing the child's symptoms. Further recommendations about treatment should be made at this point.

Etiology

The etiology of child psychopathology has many explanations which differ from case to case. Many psychopatholog disorders in children involve genetic and physiological mechanisms, though there are still many with out any physical grounds. It is absolutely imperative that multiple sources of data be gathered. Diagnosing the psychopathology of children is daunting. It is influenced by development and contest, in addition to the traditional sources. Interviews with parents about school, etc., are inadequate. Either reports from teachers or direct observation by the professional are critical. (author, Robert B. Bloom, Ph.D.) In a situation where the mother is absent a father, caregiver, or any primary caregiver to the child could be seen as the “maternal” relationship. Essentially, this would be viewed as the primary caregiver of the child who the child has the most bonding with; that the child would exude some personality traits of the caregiver. In studies of child in two age groups of pregnancy to five years, and fifteen years and twenty years, Raposa and colleagues (2011) studied the impact of psychopathology in the child-maternal relationship and how not only the mothers stress affected the child, but the child’s stress affected the mother. Historically, it was believed that mothers who suffered from post partum depression might be the reason their child suffers from mental disorders both earlier and later in development. However this correlation was found to not only reflect maternal depression on child psychopathology, but also child psychopathology could reflect on maternal depression. Children with a predisposition to psychopathology may cause higher stress in the relationship with their mother, and mothers who are suffers from psychopathology may also cause higher stress in the relationship with their child. Together, these factors push and pull the relationship and thus causing higher levels of depression, ADHD, defiant disorder, learning disabilities, and pervasive developmental disorder in both the mother and the child. The outline and summary of this study is found below: ““In looking at child-related stress, the number of past child mental health diagnoses significantly predicted a higher number of acute stressors for mothers as well as more chronic stress in the mother-child relationship at age 15. These increased levels of maternal stress and mother-child relationship stress at age 15 then predicted higher levels of maternal depression when the youth were 20 years old. Looking more closely at the data, the authors found that it was the chronic stress in the mother-child relationship and the child-related acute stressors that were the linchpins between child psychopathology and maternal depression. The stress is what fueled the fires between mother and child mental health. Going one step further, the researchers found that youth with a history of more than one diagnosis as well as youth that had externalizing disorders (e.g., conduct disorder) had the highest number of child-related stressors and the highest levels of mother-child stress. Again, all of the findings held up when other potentially stressful variables, such as economic worries and past maternal depression, were controlled for.”” This was a small study, and more research needs to be done especially with older female children, paternal relationships, maternal-paternal-child stress relationships, and/or caregiver-child stress relationships if the child is orphaned or not being raised by the biological child to reach a conclusive child-parent stress model on the effects of familial and environmental pathology on the child’s development.

Temperament

The child-parent stress and development is only one hypothesis for the etiology of child psychopathology. Other experts believe that child temperament is a large factor in the development of child psychopathology. High susceptibility to child psychopathology is marked by low levels of effortful control and high levels of emotionality and neuroticism. Parental divorce is often a large factor in childhood depression and other psychopathology disorders. Child psychopathology can cause separation anxiety from parents, attention deficit disorders in children, sleep disorders in children, aggression with both peers and adults, night terrors, extreme anxiety, anti social behavior, depression symptoms, aloof attitude, sensitive emotions, and rebellious behavior that are not in line of typical childhood development. Aggression is found to manifest in children before five years of age, and early stress and aggression in the parental-child relationship correlates with the manifestation of aggression. Aggression in children causes problematic peer relationships, difficulty adjusting, and coping problems. Children who fail to overcome acceptable ways of coping and emotion expression are put on tract for psychopathological disorders and violent and anti social behaviors into adolescence and adulthood. There is a higher rate of substance abuse in these children with coping and aggression issues, and causes a cycle of emotional instability and manifestation psychopathological disorders.

Neurology and Etiology

Borderline personality disorder is one of many psychopathology disorders a child can suffer from. In the neurobiological scheme, borderline personality disorder may have effects on the left amygdala. In a 2003 study of BPD patients versus control patients, when faced with expressions that were happy, sad, or fearful BPD patients showed significantly more activation versus control patients. In neutral faces, BPD patients attributed negative qualities to these faces. Also linked to BPD is the presence of serotonin transporter (5-HTT) in a short allele demonstrated larger amygdala neuronal activity when presented with fearful stimuli as in comparison to individuals with a long allele of 5-HTT. As found in the Dunedin longitudinal study a short allele of 5-HTT predispositions the person to have hyperactivity in the amygdala in response to trauma, and thus moderated the impact of stressful live events leading to a higher risk of depression and suicidal idealities. These same qualities were not observed in individuals with long alleles of 5-HTT. However, the environment the child is in can change in impact of this gene, proving that correct treatment, intensive social support, and a healthy and nurturing environment can modify genetic vulnerability.

Agensis of the corpus collosum and etiology

Agensis of the corpus collosum (“ACC”) is used to determine the frequency of social and behavioral problems in children with a prevalence rate of about 2-3%. ACC is described as a defect in the brain where the 200 million axons that make the corpus collosum are either completely absent, or partially gone. In many cases, the anterior commissure is still present to allow for the passing of information from one cerebral hemisphere to the other. The children are of normal intelligence level. For younger children, ages two to five, agensis of the corpus collosum causes problems in sleep. Sleep is critical for development in children, and lack of sleep can set the grounds for a manifestation of psychopathological disorders.The difficulties from ACC made lead to the etiology of child psychopathological disorders, such as depression or ADHD and manifest many autistic-like disorders that can cause future psychological disorders in later adolescence. The etiology of child psychopathology is a multi-factor path. A slew of factors must be taken into account before diagnosis of a disorder. The child’s genetics, environment, temperament, past medical history, family medical history, prevalence of symptoms and neuro-anatomical structures are all factors that should be considered when diagnosing a child with a psychopathological disorder. Many physicians believe the best prevention and help starts in the home and the school of the child, before physicians and psychologists are contacted. So while there is more awareness of child psychopathological disorders and more research to prevent and effectively treat these disorders to maintain healthy emotional health in children, there is also a negative factor in that parents, schools, and psychologists may be more sensitive and therefore over-diagnose children with these disorders. Then pharmaceutical companies and therapists have to tailor these influxes and backtrack on wrongly diagnosed children to solve the problem correctly. Psychologists and marking companies of the medicines used to treat psychopathological disorders need to be cautious of making disorders, such as child hood ADHD, glamorous ones to prevent parents from trying to label their child for any out cry or flash of aggression the child shows. Child psychopathology is a real thing that thousands of children suffer from. While hundreds of children are diagnosed with a new disorder daily, researchers are developing new strategies to beat these disorders in children to allow all children the right to a happy and healthy childhood. With further education on the symptoms and implications of child psychopathology, psychologists and physicians will improve their accuracy in diagnosing children- giving the right diagnosis and discovering the most helpful treatment and therapies for children.

Theory and Research

The current trend in the U.S. is to understand child psychopathology from a systems based perspective called developmental psychopathology. Recent emphasis has also been on understanding psychological disorders from a relational perspective with attention also given to neurobiology. Practitioners who follow attachment theory believe that early attachment experiences of children can promote adaptive strategies or lay the groundwork for maladaptive ways of coping which can later lead to mental health disorders.

Research and clinical work on child psychopathology tends to fall under several main areas: etiology, epidemiology, diagnosis, assessment, and treatment.

External Links

• Category:Childhood psychiatric disorders
• Resources for Child and Adolescent Mental Health Information about child psychopathology and treatment